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CREDIT REPORT AUTHORIZATION - Great American … · CREDIT REPORT AUTHORIZATION ... It is further understood that a credit report and complete verification will be issued by an

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CREDIT REPORT AUTHORIZATION Page 1 of 3

Please complete all information requested below. Incomplete information will delay the processing of your application. PLEASE PRINT CLEARLY Applicant Information Mr. Mrs. Ms. ___________________________________________________________________________________________________________ First Name Last Name Middle Initial ___________________________________________________________________________________________________________ Driver’s License # State Issued ___________________________________________________________________________________________________________ Date of Birth Social Security # ___________________________________________________________________________________________________________ Marital Status Email Current Address ___________________________________________________________________________________________________________ Street Apt. Number ___________________________________________________________________________________________________________ City State Zip ___________________________________________________________________________________________________________ Home Phone Mobile/Other Number ___________________________________________________________________________________________________________ Rent or Own Current Monthly Payment If rent, apartment name How long have you lived here?

If own, mortgage company

Brewery Information ___________________________________________________________________________________________________________ Legal Company Name Corporate Structure ___________________________________________________________________________________________________________ State Brewer’s License Federal Tax ID Number ___________________________________________________________________________________________________________ Physical Address City State Zip Phone Fax ___________________________________________________________________________________________________________ Billing Address City State Zip Phone ___________________________________________________________________________________________________________ Email Address Website ___________________________________________________________________________________________________________ Years in Business Estimated Annual Production Volume Kegs Owned (ex. 100- 1/2BBL, 300- 1/6BBL) Kegs in Float

CREDIT REPORT AUTHORIZATION Page 2 of 3

Ownership Information _________________________________________________________________________________________________ Principal Owners or Officers Title _________________________________________________________________________________________________ Principal Owners or Officers Title _________________________________________________________________________________________________ Principal Owners or Officers Title Banking Information ___________________________________________________________________________________________________________ Name of Bank Frequently Used Branch Address City State Zip ___________________________________________________________________________________________________________ Bank Contact Phone Fax Continued on following page

CREDIT REPORT AUTHORIZATION Page 3 of 3

Authorization/Acknowledgement This application is made for the purpose of procuring a lease from Boston Capital Leasing, LLC (the “Company”) and for credit clearance. By signing this application, you declare that all your statements in this application are true and complete. You authorize the Company to which you are applying to verify this information through any means, including consumer reporting agencies and other lenders. If you fail to answer any question or give false information, the Company may reject your application; retain all application fees and deposits as liquidated damages for its time and expense. Applicant(s) has read and understands the above statement and to the best of his/her knowledge states that all facts are true and correct. It is further understood that a credit report and complete verification will be issued by an independent agent. Any applicable application fees must be paid prior to processing of the application and are non-refundable. Our Company utilizes a credit scoring system that incorporates a statistical model comparing information on your credit profile, such as bill-paying history, the number and type of accounts, late payments, collection actions, outstanding debt, reported rental history, and the age of accounts, to the credit performance of consumers with similar profiles. (A credit scoring model only uses information on the applicant that pertains to credit; it does not use certain characteristics like - race, color, religion, sex, national origin, handicap, or familial status in its calculation.) The scoring system awards points for each factor and considers income, monthly rent, and overall credit history to evaluate how creditworthy you are. If there is limited credit history available, income and rental history will be used to evaluate your application and additional deposits may be required. APPLICATION APPROVAL PROCESS - The approval process will begin when we have received completed applications from all applicants and borrowers. The three outcomes from the approval process are accepted, conditional acceptance, or denied. Additional information and/or deposits may be required if a conditional acceptance is recommended. If you are denied credit, the Equal Credit Opportunity Act requires that the creditor give you a notice that tells you the specific reasons your application was rejected or the fact that you have the right to learn the reasons if you ask within 60 days. If a creditor says you were denied credit because you are too near your credit limits on your charge cards or you have too many credit card accounts, you may want to reapply after paying down your balances or closing some accounts. If you are denied credit because of information from a credit report, the Fair Credit Reporting Act requires the creditor to give you the name, address and phone number of the credit reporting agency that supplied the information. You should contact that agency to find out what your report said. We do not discriminate on the basis of race, color, religion, sex, national origin, handicap, or familial status. The undersigned applicant(s) and co-signer(s) hereby consent to allow Boston Capital Leasing, LLC, itself or through its designated agents and its employees, to obtain a consumer report and criminal record information, if applicable, on each of us and to obtain and verify each of our credit and employment information for the purpose of determining whether to lend money to me/us. We also agree and understand that owner and its agents and employees may obtain additional consumer reports and criminal record reports, if applicable, on each of us in the future to update or review our account. Upon my/our request, owner will tell me/us whether consumer reports or criminal record reports were requested and the names and addresses of any consumer reporting agency that provided such reports. I have read and understand the Application Acknowledgement stated above. By signing this application, you declare that all your statements in this application are true and complete. ___________________________________________________________________________________________________________ Applicant Full Name (printed) Applicant Signature Date ___________________________________________________________________________________________________________ Applicant Full Name (printed) Applicant Signature Date ___________________________________________________________________________________________________________ Applicant Full Name (printed) Applicant Signature Date For Office Use Only ___________________________________________________________________________________________________________ Credit Report Date Approved Declined